A man in his 60s suddenly felt discomfort in his lower back, and soon after he was so sore that it was difficult for him to stand up. When he went to the hospital emergency room, he found out that it was because of kidney stones. The man had a history of kidney stones in the past. However this time, the doctor told him that his kidneys had also deteriorated quite a bit.
What are the causes of various stones such as kidney stones and urinary tract stones? Why are some people more prone to developing stones? In this article, we will outline one simple way to prevent and help expel stones from your body.
Urinary Tract Stones Cause Many Problems
Most of the liquid that people consume every day is processed by the kidneys into urine, then flows into the ureter and bladder, and is finally excreted through the urethra.
Stones may form if the urine produces crystal deposition during the process of urination. Stones can appear in different places, forming kidney stones, ureteral stones, bladder stones, and urethral stones, which are collectively referred to as urinary tract stones.
People usually do not feel and do not know they have stones in their bodies without going to the hospital for a checkup. However, once the stones cause irritation or obstruction, they can trigger different symptoms depending on their location:
Kidney stones: Most urinary tract stones start with kidney stones, which can cause severe back pain and blood in the urine (hematuria) when they move. Pain can also occur if a kidney stone falls down and gets stuck in the ureter, causing edema.
Yu Chen, a urologist and assistant professor at Chang Gung Memorial Hospital in Taiwan pointed out that stable kidney stones do not necessarily need to be treated. Regular doctor visits can help to track the size of the stone and see whether it has caused an infection, blood in the urine, or pain. Sometimes, patients with kidney stones may not see obvious blood in their urine, but only feel pain, so they mistakenly think that they are injured; sometimes it’s hard to tell if the pain is caused by an injury to the lower back or a stone, so it’s best to seek medical attention when the pain is unbearable.
Ureteral stones: Most stones in this area are caused by kidney stones that fall out and become blocked. Ureteral stones not only cause severe pain in the lower back, but the pain may also radiate to the scrotum and groin. Such pain may even affect the peristalsis of the intestines, causing stomach discomfort and bloating.
Both kidney stones and ureteral stones will cause severe pain. Chen emphasized that its pain index is “second only to childbirth.”
Bladder stones: The bladder has more space than the kidney and ureter, so pain from bladder stones is only occasional. Most of the time, there will be a feeling of fullness in the lower abdomen, and symptoms of hematuria and frequent urination may occur. Stones have room to move in the bladder and tend to roll around, causing sensitive bladder and frequent urination.
Urethral stones: The urethra is a tube that connects the bladder to the outside of the body. If small stones get stuck in the urethra during the excretion process, it will cause symptoms such as hematuria, pain, weak urine stream, and irregular urination.
The degree of pain caused by urinary tract stones also depends on the size of the stones. Chen explained that the bigger the stone, the less painful it is, as it doesn’t move around; the smaller the stone, the more painful it is.
A small number of patients with kidney stones may experience back soreness and pain, but some patients can endure the pain very well, and the stones become larger over time. As a result, it cannot be treated in simple ways, and may even require surgery with a higher risk of treatment.
4 Common Causes of Stones
Calcium stones are the most common type. Tzung-Hai Yen, director of the Toxicology Department of Linkou Chang Gung Memorial Hospital in Taiwan, said that more than 80 to 90 percent of the total number of patients had calcium stones, mainly calcium oxalate and calcium phosphate ones.
Stones can be caused by many factors, but the following are the most common:
- Genetics and family history
If your parents or relatives have a history of stones, you are more likely to develop stones yourself.
Tzung-Hai Yen said, “Some patients have family members who have kidney stones, and their offspring are also more susceptible to it.” Genetics is one of the causes. Another factor is whether the lifestyle and eating habits of family members are alike.
- Water quality
Chen Yu found that water from the environment is also related to the formation of stones. He used Taiwan as an example. According to statistics, the number of patients with stones in Taoyuan City is higher than that in Taipei City. This is because the water used in Taipei comes from the Feitsui Reservoir, while Taoyuan uses the Shihmen Reservoir. The water quality of the Shihmen Reservoir is harder.
Hard water also indicates more calcium ions. When ingested into the body, they’re more likely to deposit and form stones.
Chen suggested that people who live in areas with hard water can choose to install a better water filter to make the water softer. For the same reason, it is recommended to drink purified water for patients with a history of urinary tract stones.
- Dietary habits
“Patients getting kidney stones should also watch their eating habits,” said Yen.
People who do not like drinking much water, prefer eating salty food and meat, and often consume alcohol are more prone to getting calcium oxalate stones.
People who like to eat high-purine foods, such as organ meats and seafood, are more prone to uric acid stones, as purine is metabolized into uric acid. They are also prone to gout due to high levels of uric acid in their body.
Some people may also take too many dietary supplements, such as calcium, vitamin C, or vitamin D, which may cause stones.
Yen explained that vitamin D increases the absorption of calcium and phosphorus in the gastrointestinal tract. Therefore, consuming too much vitamin D can lead to hypercalcemia and kidney stones. Oxalic acid is produced when vitamin C is metabolized in the body. Supplementation in high doses increases the concentration of oxalic acid in the urine and increases the risk of developing stones.
Chen pointed out that in general, it takes a long period of time for water quality and dietary factors to cause the formation of stones.
- Diseases and infections
Gout, diabetes, obesity, malabsorption, prostate hyperplasia, and metabolic disorders such as distal renal tubular acidosis, hyperparathyroidism, and certain genetic diseases can also cause urethral stones.
Medical research has found that kidney stone patients share comorbidities which include obesity, diabetes, gout, and other metabolic disorders. The diets of these patients are mostly high in sodium, oil, sugar, and purine.
Bladder stones are likely to accompany prostate hyperplasia because patients with prostate hyperplasia tend to have symptoms of intermittent urination, weak urine stream, and urinary retention. When a person has excess urine left in the bladder every time he or she urinates, crystals can deposit in the bladder and form bladder stones. Chen pointed out that this is very common.
Any bacteria entering the urinary tract can cause urinary tract infections, and urinary tract infections caused by Gram-negative bacteria (GNBs) are prone to stone formation.
Distal renal tubular acidosis is a major risk factor for struvite stones. Other types of voiding dysfunction, such as congenital renal outlet stenosis, ureteral stricture, congenital urinary tract stricture, and prostate hyperplasia, can also cause infection.
Yen mentioned that patients with stones are mostly male. Women develop stones mostly due to endocrine problems, such as primary hyperparathyroidism. The role of the parathyroid hormone in the kidneys is to retain calcium and excrete phosphorus. The disease will produce too much parathyroid hormone and eventually lead to the formation of kidney stones.
Other factors include weather differences. In the hot and sweat-inducing summer, if you do not replenish water in a timely manner, urinary tract stones are very likely to form.
The Easiest Way to Prevent Stones
If the factors causing urinary tract stones are caused by congenital structural problems, endocrine abnormalities, or diseases, surgery or medication is usually required to solve the root cause. For stones caused by other factors such as family history, food, or water sources, there are simple ways to prevent them. The easiest way is to drink more water.
- Drink a lot of water
Urinary tract stones of any composition can be prevented by drinking a lot of water.
“This is the best way,” said Chen. This is because stones grow slowly from crystals, before turning into larger stones. The inner diameter of the ureter is about 0.5 centimeters. If the stone is smaller than 0.5 centimeters, drinking a lot of water may flush the crystal out of the body.
Similarly, if the patient’s urinary tract stones are found to be less than 0.5 centimeters, and there is no blockage, infection, blood in the urine or pain, all they need to do is drink more water and follow up with their doctor regularly.
A 2015 meta-analysis found that every 500-milliliter increase in water intake was associated with a significantly lower risk of kidney stones. The 2020 Cochrane Review further validated that people who have had stones and drank a lot of water were less likely to have stones recur in their bodies, and even if they do recur, it will take longer.
To prevent urinary tract stones and stone recurrence, it is recommended to drink 2.5 to 3 liters of water per day.
- Consume more citric acid
Citric acid binds with calcium in the urine and reduces the concentration of calcium ions in it, thereby lowering the incidence of kidney stones. Citric acid also binds calcium oxalate crystals, preventing them from forming stones in the body.
You can add more citric acid to your diet by consuming more lemons, oranges, grapefruits, apples, and other fruits rich in citric acid. Alternatively, you can add lemon slices to water, and drink grapefruit, apple, and orange juices in moderation to reduce stone formation.
- Eat a low-sodium and moderate-calcium diet
A high-sodium diet increases calcium in the urine, which in turn combines with oxalic acid and phosphoric acid to form calcium oxalate and calcium phosphate stones. Therefore, patients with stones are advised to follow a low-sodium diet.
You may also take calcium supplements, as long as it is done in moderation.
Yen pointed out that many studies have shown that a low-calcium diet actually increases the formation of kidney stones. This is because when there is not enough calcium in the gastrointestinal tract to combine with the oxalic acid from the diet, the concentration of oxalic acid in the body will rise, increasing the excretion of oxalic acid in the urine, which increases the risk of developing stones. Similarly, calcium tablets must be taken with meals to avoid an increased risk of stone formation.
Chen believes that people who have no history of genetic disease or stones and have osteoporosis can take calcium supplements. For those with relevant medical history, additional calcium supplementation is not recommended; the consumption of tofu, dried tofu, and calcium tablets should be reduced because such people usually have enough calcium in their bodies and do not need additional supplements.
However, people who had urinary tract stones in the past are prone to recurrence. While following the diet described above may reduce the risk of developing stones, there is still a chance of recurrence.
Chen said that the recurrence rate is still 30 percent even after the stones in the body have been cleared. A 2016 study also found that people who had stones for the first time had a 50 percent recurrence rate within the first 5 years.
Furthermore, people who often develop kidney stones will also have their kidney function affected, leading to chronic kidney failure. Therefore, regular annual hospital visits for patients with urinary tract stones are recommended.
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Camille Su is a health reporter covering disease, nutrition, and investigative topics. Have a tip? kuanmi.su@epochtimes.com
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Interdisciplinary treatments aimed at both mind and body are needed for these complex conditions
From early 2021, stories have emerged of people experiencing post-COVID-19 symptoms that were so debilitating it impacted their ability to work and live a normal life.
Thirty-one-year-old Rebecca Meyer spoke on CNN in January 2021 about her 11-month struggle with long COVID symptoms for 11 months, having contracted symptoms from an infection.
Prior to infection, she was a healthy woman with no underlying health conditions. However, 11 months into the sickness, Meyer maintained that she was still “very much in the symptom-management phase of my sickness.”
Her bedroom looked like a pharmacy due to the many medications she had tried.
Speaking on her health, Meyer’s voice cracked with emotion; she needs a feeding tube due to gastroenteritis from her post-COVID symptoms, and is very much out of her four children’s lives. At the time, she reported that she has been reliant on her boyfriend, who lost his job due to the pandemic, to take care of her and the children.
“I was an active mom of four. And now I don’t get out of bed. I don’t eat, I don’t spend time with my children like I need to. This can happen to you,” she said.
Despite running over two years into the pandemic, there has been little progress on our understanding of long COVID symptoms and patients affected by it have remained largely neglected. Meanwhile, the debilitating conditions that many long COVID patients are suffering from have persisted, and are growing as a new group of disabled individuals.
Young and Disabled
While most clear out their COVID-19 symptoms in days to a few weeks, recent studies estimate that around 1 in 8 people who have been infected will have persistent COVID symptoms, despite testing negative for COVID-19.
Doctors still do not understand the drivers behind these symptoms, nor why these people are affected. Many long COVID patients, also known as long-haulers, are younger in demographic, and previously had no underlying health conditions.
However, many are hit with a myriad of mental and physiological conditions, including symptoms common to acute-COVID such as cough, fevers, shortness of breath, headaches, fatigue, and muscle aches, as well as less common COVID symptoms including brain fog, severe fatigue, chest pains, depression and anxiety, pins-and-needles, heart palpitations, sleep problems, along with other strange conditions.
Not all long COVID symptoms are debilitating, but for some, suffering from long COVID could mean a complete change to their lifestyle, and possibly even a disability.
The disabilities caused by long COVID-19 are directly related to critical organs including the brain, heart, lungs, and muscles.
1. Brain impairment: long COVID-19 impairs brain function and causes nerve damage. Studies have shown that more than 30 percent of SARS-CoV-2 viruses attack nerves. Nerves are a reservoir of hidden viruses, and nerves are connected to internal organs. Many “long-haulers” experience brain fog including difficulty sleeping, headaches, and dulled thinking and memory.
2. Impaired heart function: fatigue is a primary symptom in long haulers as well as muscle aches and increased fatigue after exercise. Many suffer from reduced cardiac output, meaning they have to reduce the intensity of their exercise and some cannot exercise without putting their health at risk.
3. Impaired respiratory function: studies have found that long COVID patients have decreased lung function due to scarring and inflammation. This can lead to decreased oxygen uptake and shortness of breath from lowered blood oxygen levels.
4. Impaired muscle function: persistent immune actions against viruses damage cells, including muscle cells and tissue. Inflammation from the immune responses can trigger inflammation in muscle fibers and induce muscle weakness.
5. Impaired blood vessel function: inflammation in the body damages cells that line blood vessels, and can possibly impair oxygen supply to organs and muscles. This can cause fatigue and aches.
A Global Problem
Disabilities from long COVID, and debilitating vaccine injuries (which often share similarities to long COVID symptoms) are growing, and becoming a problem of both national and global concern.
Debilitating long COVID symptoms can make it difficult for people to enjoy social activities and hold down a job.
News reports have emerged of people with long COVID and the vaccine injured who have faced discrimination from work and were later layovered due to their condition.
In July, 2021 the U.S. Department of Health and Human Services listed long COVID as a disability under Titles II (state and local government) and III (public accommodations) of the Americans with Disabilities Act (ADA). The statement cited that individuals claiming for long COVID disability will be assessed individually by health experts to determine if their health problems are from long COVD.
Latest U.S. government figures revealed a staggering 385,000 people have been living with symptoms of long COVID for a year or more.
A study by Brookings estimated that around 4.5 million Americans with long COVID are out of work.
This not only impacts the American workforce but is also a significant global problem both in matters of labor and healthcare.
Studies from the Netherlands showed that COVID-19 and long COVID has driven up sick leave during the pandemic. During the pandemic, the Organization for Economic Co-operation and Development published policies, encouraging implementation of sick leave income for people suffering from COVID-19 symptoms to protect their income, health, and jobs during the COVID-19 crisis.
While this provided temporary relief to the people who needed paid leave as a safety net, it also invariably increased government spending, with most countries coming out of the pandemic seeing unprecedented inflation rates.
Health conditions as a result of COVID-19 and related problems are also contributing to a shortfall in labor. Given that the world is already burdened with labor shortage from two years of pandemic, and rapidly changing work environment and career outlooks, disabilities from long COVID and vaccine injuries only add fuel to the fire.
A study published before the pandemic showed that, by 2030, more than 85 million jobs could go unfilled because there aren’t enough skilled people to take them, this number is expected to be significantly higher coming out of the pandemic.
The World Health Organization has also reported that more than 6.4 million deaths from COVID-19 and related problems. News reports have shown that there are many more vaccine injured and those who have declined vaccinations who have lost their jobs.
The expectation for work has also shifted during the pandemic. After two years of mostly working remotely with unstable employment and income, people coming out of lockdowns are also reporting mental health problems. Some came to the conclusion that work is not as important as their health or mental wellbeing and have since postponed seeking employment.
Interdisciplinary Approach to Treat Both Mind and Body
Considering that long COVID-19 is an interdisciplinary disease with a myriad of conditions that affect multiple organs, holistic health approaches have been encouraged by clinicians to treat the symptoms as a whole.
Dr. Sandrock, a professor of critical care and infectious disease medicine at the University of California, Davis School of Medicine, also said that the only universal treatment for “long-term symptoms of COVID-19” is to “improve the quality of life,” including adjusting sleep and reducing stress.
A few options of integrative care have emerged in scientific literature to resolve long COVID.
Psychological Therapies
Long COVID is detrimental to mental health. Patients often report symptoms that may be synonymous with depression and anxiety, including insomnia and muscle weakness.
Fatigue is a primary symptom of long COVID. For the patients in a state of social isolation, as well as financial and relationship difficulties, their situation can worsen fatigue, which can further cause negative impacts on mental health, and quality of life, forming a negative spiral.
People with long COVID are encouraged to seek out counseling and interact with support groups for people sharing similar conditions.
Acupuncture
Acupuncture is a holistic and energy-based medicinal practice based on the understanding that the body and its organs correspond to different energies.
Energy in excess or deficiency can affect particular organs, causing imbalances to the body. Therefore, by inserting very thin needles into acupoints at different meridians, energy balances can be restored at different organs.
Acupuncture has long been acknowledged as a medical practice that can alleviate symptoms of chronic pain.
Studies have shown that acupuncture increases the release of neurotransmitters including serotonin and noradrenaline. It also promotes the release of endorphins and melatonin and improves immune function.
The practice reasons that mental illnesses are due to imbalances in energies in various organs,
Studies have shown that acupuncture can improve mental conditions including depression and anxiety. Research indicates that depressive symptoms may be alleviated through the release of serotonin and noradrenaline, and electroencephalography readings show electroacupuncture (a form of acupuncture) may be just as effective as amitriptyline without the drug side effects.
In people with anxiety, acupuncture enhances a sense of stillness, general restfulness, and unresponsiveness to painful stimuli. It also boosts the release of endorphin, a hormone related to the feeling of happiness and satisfaction, as well as melatonin, a hormone that modulates the circadian rhythm and improves sleep.
Electroencephalography readings showed that acupuncture increased alpha waves, a wave associated with a normal wakeful state where the subject is quietly resting.
Studies have shown that acupuncture reduces patients’ needs for preoperative sedatives and the use of acupuncture comes with reduced side effects in comparison to prescription drugs for pain.
For long COVID symptoms, acupuncture is suggested to stimulate the central nervous system. Specifically it reduces the “fight or flight” stress response of the sympathetic nervous system while stimulating the parasympathetic responses (“rest and digest”).
Studies on long COVID patients suffering from chest palpitation and shortness of breath—symptoms synonymous with anxiety—found that patients experienced a decrease in the severity of the symptoms following acupuncture sessions.
Rehabilitation Interventions
Rehabilitations including physical, occupational, and speech therapy to help patients return to daily life.
Studies on aerobic and pulmonary physiotherapy, found that it improves patients’ shortness of breath, anxiety, and fear of moving. High and low-intensity aerobic exercises increased appendicular muscle mass as well as handgrip strength in patients with long COVID.
Rehabilitation and nutrition programs can also prevent and improve loss of muscle mass in patients.
Chiropractic Therapy
Chiropractic therapy is a holistic therapy that focuses on the musculoskeletal system, especially the spine. Chiropractors believe that vertebrae can become misaligned or move out of their normal position, creating subluxations that put pressure on the tissues around them.
This pressure can affect not only the immediate joints but also other visceral organs and the whole body. Therefore, chiropractors believe symptoms of stiffness, dizziness, lack of energy, general malaise, posture imbalance, neck and back stiffness or soreness, spine muscle spasms, constant headaches, and lessening of mobility are all signs of subluxation.
Vertebrae can be realigned through skeletal manipulation, which is when chiropractors apply a force to the area that is misaligned, and chiropractors use various techniques to manipulate relevant joints.
Primarily, chiropractic therapy has been used to treat back pain, however several studies have indicated that they can also treat pain in joints and limbs, muscle pain and tenderness, insomnia, headaches, and fatigue.
Meditation
Meditation, a mental exercise to attain greater spiritual awareness, is an umbrella term for various practices including yoga, taichi, breathing, and mindfulness exercises, and many more.
Meditation has been associated with many mental and physiological health benefits.
Studies have shown that meditation improves symptoms of depression, anxiety, as well as concentration, and focus.
Physically, meditation has been shown to reduce inflammation and strengthen the immune system. Studies in immune-compromised (HIV and cancer) patients showed that meditation increased or reduced the decline of immune cells, and also prevented immune aging.
Mindful meditation have been suggested to regulate and restore immune signaling. Studies showed that meditation improved interferon messaging. Interferons are dysregulated in people with severe COVID symptoms and have been suggested to also drive vaccine injury. Restoring a robust interferon pathway may improve the symptoms in people suffering from long COVID and in people sharing similar symptoms.
Meditation and mindful exercises have been encouraged during the pandemic and for long COVID patients to recover from fatigue and mental distress.
Even minimal meditation improves mental health, studies have shown novice meditators who listened to a 10 minute meditation tape before attention tests received a higher score than people who did not meditate beforehand.
Some meditation guides recommend beginners start with two to five minutes of meditation whenever they want to regulate stress and emotions. However, given that meditation could mean various practices, everyone can experiment with the duration and frequency to see what works best for them.
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